After-effects reported by women following colposcopy, cervical biopsies and LLETZ : results from the TOMBOLA trial

(2009)
After-effects reported by women following colposcopy, cervical biopsies and LLETZ : results from the TOMBOLA trial.
BJOG: An International Journal of Obstetrics & Gynaecology, Vol.116
(No.11).
pp. 1506-1514.
ISSN 1470-0328
Full text not available from this repository.

Population Nine hundred-and-twenty-nine women, aged 20–59, with low-grade cytology, who had completed their initial colposcopic management.

Methods Women completed questionnaires on after-effects at approximately 6-weeks, and on menstruation at 4-months, post-colposcopy.

Main outcome measures Frequency of pain, bleeding, discharge; changes to first menstrual period post-colposcopy.

Results Seven hundred-and-fifty-one women (80%) completed the 6-week questionnaire. Of women who had only a colposcopic examination, 14–18% reported pain, bleeding or discharge. Around half of women who had biopsies only and two-thirds treated by LLETZ reported pain or discharge (biopsies: 53% pain, 46% discharge; LLETZ: 67% pain, 63% discharge). The frequency of bleeding was similar in the biopsy (79%) and LLETZ groups (87%). Women treated by LLETZ reported bleeding and discharge of significantly longer duration than other women. The duration of pain was similar across management groups. Forty-three percent of women managed by biopsies and 71% managed by LLETZ reported some change to their first period post-colposcopy, as did 29% who only had a colposcopic examination.

Conclusions Cervical punch biopsies and, especially, LLETZ carry a substantial risk of after-effects. After-effects are also reported by women managed solely by colposcopic examination. Ensuring that women are fully informed about after-effects may help to alleviate anxiety and provide reassurance, thereby minimising the harms of screening.